Usunięcie zdrowego zęba też może być zwolnione z VAT
Ekstrakcja zdrowego zęba przeszkadzająca w założeniu aparatu ortodontycznego lub hamującego wzrost innych zębów jest dokonywana w celach profilaktycznych, a co za tym idzie, podlega zwolnieniu od podatku na podstawie art. 43 ust. 1 pkt 19 lit. a) ustawy o VAT.
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Czy ekstrakcja zęba (usunięcie) w celach leczniczych - ząb chory i zęba zdrowy, ale taki, który np. przeszkadza w celach założenia aparatu ortodontycznego lub hamuje wzrost innych zębów (szczęka zbyt wąska) jest rozróżniona pod kątem podatku VAT (jeden zabieg może korzystać ze zwolnienia przedmiotowego w VAT a inny nie korzysta ze zwolnienia)?
Odpowiedź
W opisanym przypadku ekstrakcja zdrowego zęba jest dokonywana w celach profilaktycznych, a co za tym idzie, podlega zwolnieniu od podatku na podstawie art. 43 ust. 1 pkt 19 lit. a) u.p.t.u.
Uzasadnienie
Zwolnieniu od podatku od towarów i usług podlegają usługi w zakresie opieki medycznej, służące profilaktyce, zachowaniu, ratowaniu, przywracaniu i poprawie zdrowia, świadczone w ramach wykonywania zawodów: lekarza i lekarza dentysty (art. 43 ust. 1 pkt 19 lit. a ustawy z 11.03.2004 r. o podatku od towarów i usług – dalej u.p.t.u.)
Z orzecznictwa Trybunału Sprawiedliwości UE jednoznacznie wynika, że zwolnieniu od podatku nie powinny podlegać takie usługi, których celem nie jest ochrona zdrowia. W wyroku w sprawie L.u.P. GmbH (C-106/05) Trybunał stwierdził: "(...) pojęcia "opieki medycznej" oraz "świadczeń opieki medycznej" (...) odnoszą się do świadczeń, które służą diagnozie, opiece oraz w miarę możliwości leczeniu chorób lub zaburzeń zdrowia". Natomiast w sprawie CopyGene (C-262/08) wskazano, iż "Cel usługi medycznej określa, czy powinna ona korzystać ze zwolnienia; jeżeli z kontekstu wynika, że jej głównym celem nie jest ochrona, utrzymanie bądź przywrócenie zdrowia, lecz inny cel, to wówczas zwolnienie nie będzie miało zastosowania". Innymi słowy, aby podlegać zwolnieniu świadczenie powinno mieć cel terapeutyczny. Tym samym, liczy się nie charakter usługi, ale jej cel.
Podkreślenia wymaga, iż orzecznictwo Trybunału Sprawiedliwości UE wskazuje, że ze zwolnienia mogą korzystać również usługi medyczne realizowane w celach profilaktycznych (wyrok w sprawie Unterpertinger, C-212/01).
Wykonywane usługi protetyczne polegające na zakładaniu pacjentowi protez, mostów czy koron przeprowadzane przez lekarzy stomatologów, spełniają podstawowe warunki umożliwiające zastosowanie zwolnienia od podatku, tj. ich bezpośrednim celem jest profilaktyka, zachowanie, ratowanie, przywracanie i poprawa zdrowia – gdyż ich celem jest m.in. przywrócenie czynności i funkcji narządu żucia. Tym samym, jeśli są świadczone przez lekarza dentystę podlegają zwolnieniu na podstawie art. 43 ust. 1 pkt 19 lit. a u.p.t.u. (por. interpretacja indywidualna Dyrektora Izby Skarbowej w Poznaniu z 4 października 2011 r., ILPP2/443-1140/11-4/SJ).
W świetle powyższego, uważam że ekstrakcja zdrowego zęba jest dokonywana w celach profilaktycznych, a co za tym idzie, podlega zwolnieniu od podatku na podstawie art. 43 ust. 1 pkt 19 lit. a) u.p.t.u.
